A new echocardiographic model for quantifying three-dimensional endocardial surface area

A new technique for quantitatively mapping the three-dimensional left ventricular endocardial surface was developed, using measurements from standard cross-sectional echocardiographic images. To validate the accuracy of this echocardiographic mapping technique in an animal model, the endocardial areas of 15 excised canine ventricles were calculated using measurements made from echocardiographic studies of the hearts and compared with areas determined with latex casts of the same ventricles. Close correlation (r = 0.87, p < 0.001) between these two measures of endocardial area provided preliminary confirmation of the accuracy of the maps.To further characterize the mapping algorithm, it was translated into computer format and used to map the surfaces of idealized hemiellipsoids. Areas measured with this mapping technique closely approximated the actual areas of idealized surfaces with a wide spectrum of shapes; maps were particularly accurate for ellipsoids with shapes similar to those of undistorted human ventricles. Also, the accuracies of area calculations were relatively insensitive to deviation from the assumed positions of the echocardiographic short-axis planes. Finally, although the accuracy of the mapping technique improved as data from more transverse planes were added, the procedure proved reliable for estimating surface areas when data from only three planes were used. These studies confirm the accuracy of the echocardiographic mapping technique, and they suggest that the resulting planar plots might be useful as templates for localizing and quantifying the overall extent of abnormal wall motion

Unusual sequelae after percutaneous mitral valvuloplasty: A Doppler echocardiographic study

AbstractPercutaneous mitral valvuloplasty is a promising new technique for the treatment of mitral stenosis, with a relatively low complication rate reported to date. To assess the sequelae of this procedure, Doppler echocardiographic studies were prospectively performed before and after percutaneous mitral valvuloplasty in a series of 172 patients (mean age 53 ± 17 years). After balloon dilation, mitral valve area increased from 0.9 ± 0.3 to 2 ± 0.8 cm2(p < 0.0001), mean gradient decreased from 16 ± 6 to 6 ± 3 mm Hg (p < 0.0001) and mean left atrial pressure decreased from 24 ± 7 to 14 ± 6 mm Hg (p < 0.0001).Although most patients were symptomatically improved, six (4%) were identified who had unusual sequelae evident on Doppler echocardiographic examination immediately after percutaneous mitral valvuloplasty. These included rupture of a posterior mitral valve leaflet, producing a flail distal leaflet portion with severe mitral regurgitation detected on Doppler color flow mapping (n = 1); asymptomatic rupture of the chordae tendineae attached to the anterior mitral valve leaflet with systolic anterior motion of the ruptured chordae into the left ventricular outflow tract (n = 1); a double-orifice mitral valve (n = 1); and evidence of a tear in the anterior mitral valve leaflet (n = 3), producing on both pulsed Doppler ultrasound and color flow mapping a second discrete jet of mitral regurgitation in addition to regurgitation through the main mitral valve orifice. All six patients made a satisfactory recovery and none has required mitral valve replacement.In a small percent of cases, percutaneous mitral valvuloplasty may produce unusual disruption of the mitral valve and supporting apparatus that may be readily detected by Doppler echocardiographic studies

Galaxy formation in the Planck cosmology - I. Matching the observed evolution of star formation rates, colours and stellar masses

We have updated the Munich galaxy formation model to the Planck first-year cosmology, while modifying the treatment of baryonic processes to reproduce recent data on the abundance and passive fractions of galaxies from z = 3 down to z = 0. Matching these more extensive and more precise observational results requires us to delay the reincorporation of wind ejecta, to lower the surface density threshold for turning cold gas into stars, to eliminate ram-pressure stripping in haloes less massive than ∼1014 M⊙, and to modify our model for radio mode feedback. These changes cure the most obvious failings of our previous models, namely the overly early formation of low-mass galaxies and the overly large fraction of them that are passive at late times. The new model is calibrated to reproduce the observed evolution both of the stellar mass function and of the distribution of star formation rate at each stellar mass. Massive galaxies (log M⋆/M⊙ ≥ 11.0) assemble most of their mass before z = 1 and are predominantly old and passive at z = 0, while lower mass galaxies assemble later and, for log M⋆/M⊙ ≤ 9.5, are still predominantly blue and star forming at z = 0. This phenomenological but physically based model allows the observations to be interpreted in terms of the efficiency of the various processes that control the formation and evolution of galaxies as a function of their stellar mass, gas content, environment and time

From dwarf spheroidals to cDs: Simulating the galaxy population in a LCDM cosmology

We apply updated semi-analytic galaxy formation models simultaneously to the stored halo/subhalo merger trees of the Millennium and Millennium-II simulations. These differ by a factor of 125 in mass resolution, allowing explicit testing of resolution effects on predicted galaxy properties. We have revised the treatments of the transition between the rapid infall and cooling flow regimes of gas accretion, of the sizes of bulges and of gaseous and stellar disks, of supernova feedback, of the transition between central and satellite status as galaxies fall into larger systems, and of gas and star stripping once they become satellites. Plausible values of efficiency and scaling parameters yield an excellent fit not only to the observed abundance of low-redshift galaxies over 5 orders of magnitude in stellar mass and 9 magnitudes in luminosity, but also to the observed abundance of Milky Way satellites. This suggests that reionisation effects may not be needed to solve the "missing satellite" problem except, perhaps, for the faintest objects. The same model matches the observed large-scale clustering of galaxies as a function of stellar mass and colour. The fit remains excellent down to ~30kpc for massive galaxies. For M* < 6 x 10^10Msun, however, the model overpredicts clustering at scales below 1 Mpc, suggesting that the sigma_8 adopted in the simulations (0.9) is too high. Galaxy distributions within rich clusters agree between the simulations and match those observed, but only if galaxies without dark matter subhalos (so-called orphans) are included. Our model predicts a larger passive fraction among low-mass galaxies than is observed, as well as an overabundance of ~10^10Msun galaxies beyond z~0.6, reflecting deficiencies in the way star-formation rates are modelled.Comment: Accepted for publication in MNRAS. SQL databases containing the full galaxy data at all redshifts and for both the Millennium and Millennium-II simulations are publicly released at http://www.mpa-garching.mpg.de/millenniu

The Solution Chemistry of Cu2+–tren Complexes Revisited: Exploring the Role of Species That Are Not Trigonal Bipyramidal

Potentiometric and spectrophotometric titrations indicate that aqueous solutions that contain equimolar amounts of Cu2+ and tren contain the HCuL3+, CuL2+ and CuL(OH)+ species and that their relative concentrations depend on the pH of the solution. The stability constants and the UV/Vis and EPR spectra of the three species have been determined. The position of the absorption maximum clearly corresponds to a trigonal bipyramidal (tbp) geometry for CuL2+, whereas for HCuL3+ and CuL(OH)+ there are also bands that could correspond to square pyramidal (sp) complexes, but the EPR spectra indicate that only HCuL3+ can be considered to be sp. When any of these species is mixed with an excess of acid, an intermediate is formed within the mixing time of the stopped-flow technique. This intermediate undergoes complete decomposition in a second slower step. Interestingly, the spectrum of this intermediate is typical of sp geometry. Kinetic studies on complex formation in general indicate that complexation occurs in a single step, although under certain conditions an additional step has been observed that probably corresponds to the conversion of CuL2+ to HCuL3+, and the spectral changes indicate that the process involves structural reorganization from tbp to sp geometry. DFT and TDDFT calculations have been carried out for the three stable species, as well as for species in a higher protonation state. The results indicate that CuL2+ exists as a species with tetradentate tren and tbp geometry, although a wide range of distortions between the ideal tbp geometry and a geometry closer to sp is possible with a very modest energy cost. The energy change associated with hydrolysis of one of the Cu– N bonds to give a species with tridentate tren was found to be slightly higher than that previously found for a related ligand, which contains a substituent at one of the terminal amino groups. For CuL(OH)+, the calculations suggest that an equilibrium exists between species with essentially the same energy but different geometries, each one of the species is closer to one of the ideal tbp and sp limits. For HCuL3+, the relevance of the sp geometry was confirmed by the calculations

UV/Optical disk reverberation lags despite a faint X-ray corona in the AGN Mrk 335

We present the first results from a 100-day Swift, NICER and ground-based X-ray/UV/optical reverberation mapping campaign of the Narrow-Line Seyfert 1 Mrk 335, when it was in an unprecedented low X-ray flux state. Despite dramatic suppression of the X-ray variability, we still observe UV/optical lags as expected from disk reverberation. Moreover, the UV/optical lags are consistent with archival observations when the X-ray luminosity was >10 times higher. Interestingly, both low- and high-flux states reveal UV/optical lags that are 6-11 times longer than expected from a thin disk. These long lags are often interpreted as due to contamination from the broad line region, however the u band excess lag (containing the Balmer jump from the diffuse continuum) is less prevalent than in other AGN. The Swift campaign showed a low X-ray-to-optical correlation (similar to previous campaigns), but NICER and ground-based monitoring continued for another two weeks, during which the optical rose to the highest level of the campaign, followed ~10 days later by a sharp rise in X-rays. While the low X-ray countrate and relatively large systematic uncertainties in the NICER background make this measurement challenging, if the optical does lead X-rays in this flare, this indicates a departure from the zeroth-order reprocessing picture. If the optical flare is due to an increase in mass accretion rate, this occurs on much shorter than the viscous timescale. Alternatively, the optical could be responding to an intrinsic rise in X-rays that is initially hidden from our line-of-sight.Comment: Accepted for publication in the Astrophysical Journal. 15 pages, 8 figures, 3 table

Immaturity of the Oculomotor Saccade and Vergence Interaction in Dyslexic Children: Evidence from a Reading and Visual Search Study

Studies comparing binocular eye movements during reading and visual search in dyslexic children are, at our knowledge, inexistent. In the present study we examined ocular motor characteristics in dyslexic children versus two groups of non dyslexic children with chronological/reading age-matched. Binocular eye movements were recorded by an infrared system (mobileEBT®, e(ye)BRAIN) in twelve dyslexic children (mean age 11 years old) and a group of chronological age-matched (N = 9) and reading age-matched (N = 10) non dyslexic children. Two visual tasks were used: text reading and visual search. Independently of the task, the ocular motor behavior in dyslexic children is similar to those reported in reading age-matched non dyslexic children: many and longer fixations as well as poor quality of binocular coordination during and after the saccades. In contrast, chronological age-matched non dyslexic children showed a small number of fixations and short duration of fixations in reading task with respect to visual search task; furthermore their saccades were well yoked in both tasks. The atypical eye movement's patterns observed in dyslexic children suggest a deficiency in the visual attentional processing as well as an immaturity of the ocular motor saccade and vergence systems interaction

Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5\u201374.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care